Provider Demographics
NPI:1184629677
Name:SCHLECHT, BIRUTE BALCIUNAS (DPM)
Entity Type:Individual
Prefix:MRS
First Name:BIRUTE
Middle Name:BALCIUNAS
Last Name:SCHLECHT
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:BIRUTE
Other - Middle Name:ZITA
Other - Last Name:BALCIUNAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:2901 35TH ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-5119
Mailing Address - Country:US
Mailing Address - Phone:262-652-6555
Mailing Address - Fax:262-652-7414
Practice Address - Street 1:2901 35TH ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-5119
Practice Address - Country:US
Practice Address - Phone:262-652-6555
Practice Address - Fax:262-652-7414
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI711-025213E00000X
IL016-004620213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43221800Medicaid
WI000083491Medicare ID - Type Unspecified
WI43221800Medicaid
WI4628310002Medicare NSC